March 2007 NACBHDD Newsletter
The Newsletter of the National Association of County Behavioral Health and Developmental Disability Directors
In this Issue...
NACBHD is Now NACBHDD
The Board agreed at its latest meeting to officially change the acronym for the organization to NACBHDD in order to better and more accurately represent the Developmental Disability membership and mission of the organization.
Search for a New President and CEO Advances to the Interview Stage
As previously reported, NACBHDD President and CEO Melissa Staats resigned her position in the organization effective December 31 to become the Director of Mental Health in Westchester County, New York. (Staats continues to be a member of NACBHDD.) In the meantime, Tom Joseph, Senior Associate, Waterman & Associates, is working to ensure that NACBHDD is represented on all policy issues. For more information about Joseph and his experience, see the February newsletter.
The search committee, chaired by Leon Evans, Executive Director, the Center for Health Care Services, San Antonio, Texas, has been busy reviewing applications over the past few months, and has narrowed the field to several candidates, who will be interviewed in early May.
Member Testifies at Hearing on Mentally Ill Offender Treatment and Crime Reduction Act
NACBHDD Vice Chair Leon Evans, Executive Director, the Center for Health Care Services, San Antonio, Texas, recently testified at a hearing regarding the "Mentally Ill Offender Treatment and Crime Reduction Act." In his testimony, Evans described the local collaboration in Bexar County, Texas which created a very successful community initiative known as "The Bexar County Jail Diversion Program." In the last two years, this collaboration has been nationally recognized for its excellence in service, focusing on first line contact within the jail diversion continuum, including the American Psychiatric Association's 2006 national "Gold Award" recognizing their program.
As Evans noted in his testimony, "In Fiscal Year 2004, our first economic study revealed that in Bexar County, with the diversion of over 1,700 people an estimated $3.8 million to $5.0 million dollars in avoided costs was actualized within the Bexar County Criminal Justice System.
"Economically, it makes sense to divert from incarceration and treat non-violent persons with serious mental illness in different venues and make available crisis services and other treatment modalities outside the criminal justice system. This protects the dignity of persons with a severe mental illness while making sure our county, state and federal dollars are spent in the most effective and efficient way possible. By not providing the appropriate intervention and treatment we are finding that people with mental illness are being incarcerated. This inappropriate system of incarceration could be considered cruel and unusual punishment."
To access the complete testimony, click here.
NACBHDD Has Moved: New Contact Information
As of January 30, NACBHDD is now located at:
25 Massachusetts Avenue, N.W.
Suite 500
Washington, D.C. 20001
The telephone number, fax, e-mail addresses and Web address remain the same:
Phone: (202) 661-8816, Fax: (202) 661-8871
E-mail: mgilmore@nacbhd.org
Web site: www.nacbhd.org
Tom Joseph provided the following information on recent Medicaid and SCHIP activities:
Medicaid: In mid-March, NACBHDD sent comments to the Centers for Medicare and Medicaid Services opposing the proposed rule which would place further restrictions on the ability of state and local authorities to raise funds as a match to draw down federal dollars. The federal savings of $5 billion over the next five years is viewed as a shift in costs to state and local governments. As NACBHDD noted in its written response, "Given our service responsibilities and local financial contributions to the safety net, any reduction in federal support will shift costs to states and localities and place further stress on our systems of care." Fifty-eight members of the Senate also sent a bi-partisan letter to HHS Secretary Leavitt urging him to withdraw the rule.
The formal comment period has ended. Senator Durbin (D-IL) successfully offered an amendment to the Iraq war funding supplemental to delay the implementation of the regulations for two years. The House bill does not contain the provision so it will be a matter for the Houise and Senate conference committee to resolve in April. NACBHDD staff continues to be involved in the issue, and will alert the membership of any new developments.
SCHIP: States anticipating a shortfall in the next few months in their federal funding for the State Children's Health Insurance Program (SCHIP) received welcome news in March that the House and Senate intend to fund the $750 million necessary to ensure that their programs can continue to operate through the remainder of this fiscal year. The vehicle to do so, however, has been the source of significant controversy. SCHIP has been added to the $125 billion emergency supplemental for the wars in Iraq and Afghanistan. The bill will not pass until Congress resolves the issue on whether it should place a timetable on withdrawing troops from Iraq.
SCHIP is due to be reauthorized this year. Hearings have been held, but no mark ups of the measure have occurred.
Members Urged to Contact Congress Regarding Medicaid Reimbursement Rule
The following notice is reprinted from Maeghan Gilmore's March 12 email to members regarding the Medicaid reimbursement rule:
NACBHDD Members -
At our recent legislative and policy conference the NACBHDD Medicaid committee determined that it would be beneficial to contact members of Congress regarding the Medicaid reimbursement rule. Attached is a draft letter for your use to modify and send to your U.S. Representatives and Senators urging them to stop the proposed Medicaid rule which will likely restrict the ability of state and local governments to fund their Medicaid programs. To access the draft letter, click here.
The Medicaid director from the Centers for Medicare and Medicaid Services (CMS) made it clear at NACBHDD's recent conference that CMS intends to move ahead with this rule. With this in mind, working with Congress is an important step in blocking this rule from implementation.
Letters to Congress urging them to intervene are critical. In addition to mailing the letter, faxing or e-mailing your response would ensure that your elected officials in Washington receive your correspondence in a timely manner. You may find additional information on how to reach your representative at: www.house.gov and your Senators at www.senate.gov Please e-mail a copy to Maeghan Gilmore at NACBHDD mgilmore@nacbhd.org so we can document the response from our members.
Additionally, NACBHDD will be sending formal comments to CMS stating its concerns from a national perspective.
Congress needs to hear from home on this issue. Please respond if at all possible
If you have any questions, please contact Tom Joseph, tj@wafed.com or Maeghan Gilmore, mgilmore@nacbhd.org.
NACBHDD Member Works on Community Capacity to Care for Families of Soldiers Returning From the Iraq War: Family Behavioral Health Needs Are Potential "Mini Crisis"
In the February newsletter, NACBHDD reported on James Castro's (Director of Children & Adolescent Services, the Center for Health Care Services [CHCS], San Antonio, Texas) work on a paper he hopes to present to Congress to gain sponsorship for behavioral health support for children, spouses, and extended families of soldiers returning from the Iraq war. (Castro works with Leon Evans, NACBHDD Board member and President/CEO of CHCS.) Castro and Evans are in a good position to hear about the impact of the war on spouses, children, and extended family and caregivers; Audie L. Murphy Memorial Veterans Hospital is located in San Antonio and Brooke Army Medical Center is in nearby Fort Sam Houston.
The impact on families
A recent VA report says that as many as one-third of the soldiers returning home from Iraq may have Post Traumatic Stress Disorder (PTSD). The symptoms of PTSD pose significant stressors for families and have a behavioral health impact on the soldiers' spouses and children. Castro has reviewed and compiled a growing amount of data demonstrating that the families of soldiers returning from Iraq, especially those families of soldiers suffering from PTSD, are suffering secondary behavioral health issues, such as anxiety, depression, and substance abuse. For example, he says pediatricians from Brooke Army Medical Center are seeing more children of Iraq veterans who are experiencing secondary trauma. In addition, spouses of soldiers returning from Iraq, who are responsible for caring for the children, are also suffering from the secondary stressors.
Castro hopes to correlate the numbers of children and spouses likely impacted in his research. In addition, Castro says it is important to remember that symptoms of PTSD do not always exhibit immediately, and may in fact, take years to exhibit. There needs to be research on the number of children, spouses, and extended family/caregivers at risk, and from that data, a capacity for care can be built.
While improved medical care has allowed more soldiers to survive, there may be more soldiers with traumatic injuries with long-term consequences. There are 22,565 wounded at this point, and over 3,000 dead. This means that the burden on secondary caregivers will be profound, and consequently, the impact on communities is expected to be significant. Castro refers to it as a potential "mini-crisis."
The Update: Paper Has Been Circulated to Stakeholders
The paper, "The Growing Behavioral Health Needs of Active, Reserve and National Guard Members, Their Children, Spouses and Extended Family" has been circulated to stakeholders, including NACBHDD, Brooke Army Medical Center Department of Pediatrics and Department of Behavioral Medicine, University of Texas Health Science Center Research Department, University Health System, and The Center for Health Care Services. Castro says, "There are plans to use this information to build a national consensus that transformation is necessary to meet the critical mental health needs of our military service members, their children and families." To view the paper, click here.
For questions or for more information, contact James Castro at: JCastro@chcs.hhscn.org.
DSM-V Work Slated to Begin Soon; Access DSM-V Prelude Project Online
The website, www.dsm5.org, has been developed by the American Psychiatric Association to keep professionals and the public informed about the process around work on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The site is also a tool for enriching the research base before formal work begins and for providing commentary on problems in DSM-IV and suggestions for DSM-V. A timeline for work on the manual, papers on meetings related to the project, and a web page for DSM-IV-TR can be accessed through the site, and users can register for a newsletter that provides updates on the progress of the work related to the manual.
Unstrange Minds: An Anthropologist and Father Explores Autism
The Developmental Disability Committee has identified autism spectrum disorders as a priority issue for NACBHDD. In an ongoing effort to cover developments related to autism spectrum disorders, the newsletter has been covering recent developments, including the Combating Autism Act, S. 843, signed by President Bush on December 19 (see January newsletter) and the Autism Services Bill just introduced in the Senate (see below).
This month, NACBHDD spoke with Roy Richard Grinker, Ph.D., Professor of Anthropology and Director of the George Washington University Institute for Ethnographic Research, in Washington, D.C. and the author of Unstrange Minds: Remapping the World of Autism. He is the father of a teenage girl, Isabel, with autism, and the grandson, son, and husband of psychiatrists. Unstrange Minds was published by Basic Books this year, and Grinker has spoken about the book and autism around the country, including on NPR's Diane Rehm Show in January and Diane Sawyer's Prime Time Special on N. Korea in December.
In addition to the anthropological expertise and very personal perspective Grinker brings to the issue as the father of an adolescent with autism, he is no stranger to psychiatry and the behavioral health field. His great grandfather practiced psychoanalysis and later switched to neurology. His grandfather, Roy R. Grinker, Sr., founded the University of Chicago psychiatry department, and was the founding editor of the Archives of General Psychiatry. (His grandfather was analyzed by Freud.) His father, Roy R. Grinker, Jr., M.D., still practices psychiatry and psychoanalysis. And, Grinker is married to a psychiatrist. Throughout the book, he offers authoritative commentary from experts in the behavioral health field, including Daniel Pine, MD, who will lead the effort in child disorders for DSM-V, projected for publication in 2011. Pine is Chief of Child and Adolescent Research in the Mood and Anxiety Disorders Program at NIMH.
Grinker's book is helpful and informative in examining some of the issues about NACBHDD members are concerned, and he expanded on those issues in the interview.
Stigma B
Grinker notes that stigma has decreased because of changes in our culture, and that there has been a big shift in terms of hiding mental illness, developmental disabilities, and learning disabilities. He cites the decreased stigma around HIV and children with special needs. For example, children with special needs are now expected to advocate for themselves. In fact, a child with dyslexia does not hide the learning issue, but is encouraged to deal with the educational accommodations process.
Most notably, Grinker says, we are at the point as a culture where parents are not blamed for disorders such as autism; instead autism is recognized as a genetic disorder. "We live in an advocacy culture in which we are being open about all disorders in way we've never seen before." And, an important factor contributing to the ability to be open about discussing autism, says Grinker, is the "ammunition" that has been provided by the "unsung heroes in our culture – the epidemiologists," who he characterizes as doing "more accurate and better research."
The numbers
Currently, the most accurate rates of autism are 1 in 150, as reported by the Centers for Disease Control and Prevention (CDC) in February. (To access the CDC press release "CDC Releases New Data on Autism Spectrum Disorders (ASDs) from Multiple Communities in the United States" and related information,
click here.
While these numbers point to a profound public health issue, Grinker is careful to explain that this does not mean that there were not 1 in 150 cases of autism a hundred years ago; he feels that there are simply better methods of assessment and diagnosis now. For example, he has recently completed data collection on the first-ever prevalence study of autism in Korea, with co-investigators Young-Shin Kim, M.D., Ph.D. of Yale University, Yun-Joo Koh, Ph.D. (site PI in Korea), Eric Fombonne, M.D. of McGill University, Bennett Leventhal, M.D. of the University of Illinois, and Dong-Ho Song, M.D. of Yonsei University (Korea). (The project is funded by a grant from the National Alliance for Autism Research/Autism Speaks.) Findings will be based on a total population study of 35,000 children ages 6 through 12. While the final report is not due until the end of the year, Grinker suspects that the study probably will find numbers on par with the most recent numbers from the CDC. Grinker says it is important to recognize that in our country classifications interact significantly with services; and right now, autism is a useful classification which helps obtain real services.
What accounts for the rise in the prevalence rate of autism spectrum disorders?
According to Grinker, there are seven major factors affecting the rise in prevalence rates (pp. 156-162). They can be summarized as follows:
Medicaid waiver
Although these waivers vary from state to state, Grinker feels the hardships among families with a child diagnosed with autism are common, and that it is difficult for many families to pay for the services they need, including respite care and the medications that many children with autism are now taking. In his discussions with clinicians, Grinker found that many clinicians do not always feel that their diagnosis is totally accurate. For example, a child may have both mental retardation and autism, but a sole diagnosis of autism may allow the family to obtain more services for the child.
On the other hand, while families impacted by autism may have a number of similar needs, Grinker points out the extremely specific and individualistic nature of the disorder. For example, their physician feels that Isabel benefits from the social exposure to peers; and therefore, the direct one-on-one services under the Medicaid waiver would not be the best fit for their family. However, other families may have quite different needs. For example, some children with autism are "runners" and may wander away without warning. In these cases, some state Medicaid waivers can help pay for the fence that some families need around their property. Hopefully, Grinker emphasizes, a team of people with different areas of expertise will be involved in helping children with autism and their families.
And, he points out, what is often lacking are services for adults with autism. For example, Connecticut and Tennessee do not have services for adults with autism who do not have mental retardation. (Connecticut was due to have a hearing about this issue earlier in March, but the hearing was delayed due to discussion of the HPV vaccine.) Grinker says this type of interaction of services and diagnoses can impact whether or not we even know about adult cases of autism. He cites a 60-year-old Tennessee woman recently diagnosed with autism who had been diagnosed with mental retardation her entire life, and he notes, as a result there has been "absolutely no record that she has autism."
Early diagnosis and early intervention
Grinker says that the scientists he speaks with are "excited about the fact that autism is being diagnosed earlier and earlier." He cites Rebecca Landa's Baby Sibs project, which was funded by the National Alliance for Autism Research for three years, and then granted a larger award by the National Institutes of Health. (To access the article "Baby Sibs Research Helps Earlier Diagnosis NAAR-Funded Infant Siblings Studies Lead to Major Advance in Earlier Diagnosis for Autism Spectrum Disorders," click here ) In addition, Dr. Susan Bryson at Dalhousie University in Nova Scotia is involved in very important research on diagnosis as early as six months of age. See http://www.medhunters.com/articles/learningToSmile.html. for Bryson's five to seven early "flags" for autism and an article on her research.
Treatment
Speech, play, and occupational therapy, as well as a system of positive reinforcement to reinforce positive behaviors are all treatments Grinker reviews in his book. He explains applied behavioral analysis (ABA), one of the most common therapies for children with severe autism and often lauded as the "best nonmedical intervention for autism" as often hotly debated by scientists who "argue that the results reported by researchers with a scientific or financial interest in ABA have not been replicated elsewhere" (p. 177). While it is clear that there is still no one single "best" treatment for autism, Grinker's book quite consistently points to the need for each family to assess and determine what works best for their child.
The Combating Autism Act
Grinker reports that scientists are ambivalent about the Combating Autism Act because "you don't know where the decisions will be made." For example, many advances were made related to HIV through cancer research, and scientists researching autism are opposed to the Act because they do not want a precedent set regarding research and where the funding goes for it. For details on the Combating Autism Act, see the February newsletter.
Research: What should be emphasized?
"The vast, vast majority of scientists (over 90%) who work on autism are more interested in treatment, intervention, and medication," says Grinker [as opposed to finding a cure]. Others who may be ambivalent about the Combating Autism Act are individuals with autism or Asperger's who do not want to be "cured" because of the uniqueness they believe autism affords their personalities.
Grinker cites a study published online in the March 16 issue of Science Express that revealed that there may be as many as 100 genes involved with autism, and that there may be different genes involved for boys and girls. For an overview of the article, "Tiny, Spontaneous Gene Mutations May Boost Autism Risk," see http://www.nimh.nih.gov/press/gene-mutations-autism.cfm.
Caring for those with autism
Grinker feels "we should look at where we are now – people with autism may live in group homes or some may be married and living independently." One could argue, he says, that we are not going to have any more of a crisis in care than we have now because of our awareness of the issue. He is actually optimistic that we will be better able to help people with autism – "they are right there with us where they have been all along."
In his closing chapter, "Beyond the Curve," Grinker reflects that for most parents he has spoken with "a good outcome means that their child will be able to live independently without close supervision." While he is not as concerned about independence, he points to the importance of self-advocacy, social connections, continued adult learning, minimal emotional distress, and the importance of a "stable network of family and friends." However, no matter what emphasis a family places on independence, Grinker describes the well-integrated focus needed to care for an individual with autism, "I know that it takes more than a village to raise a child; it takes a village and comprehensive mental-health care and educational policies to raise a child with autism."
For more information on Unstrange Minds or on Grinker, including his research, links to books and organizations, and a schedule of his readings, speeches, and radio engagements across the country, see www.ustrangeminds.com.
Autism Services Bill Introduced in the Senate
The Autism Society of America issued the following press release March 20. NACBHDD will follow up on this important proposed legislation in a future newsletter.
Senators Clinton and Allard Introduce Historic Autism Services Bill
Autism Society of America Welcomes Senate Legislation to Support Autism Community
The Autism Society of America (ASA) hailed today's introduction of the Expanding the Promise for Individuals with Autism Act of 2007 as landmark progress for Americans living with autism and their families. This legislation, if passed, would provide approximately $350 million to improve access to comprehensive treatments, interventions, and services for individuals with autism and their families.
ASA strongly supports the Expanding the Promise for Individuals with Autism Act of 2007 and urges all Senators to cosponsor this important legislation. "This bill specifically addresses the most critically important issue to the autism community today -- obtaining appropriate services across the lifespan," said Lee Grossman, President and CEO of ASA. "Our families and individuals with autism are pleased that their voices have been heard by Senators Clinton and Allard, and encourage their Senate colleagues to support this legislation."
The proposed legislation aims to:
ASA, its national network of chapters and other autism organizations joined with Easter Seals, National Disability Rights Network, Association of University Centers on Disabilities and other organizations delivering needed services in calling on the Congressional leadership to support this welcome—and critical—federal legislation for families.
To access a summary of the Expanding the Promise for Individuals with Autism Act of 2007, see the Autism Society of America web site at www.autism-society.org.
Asperger's Resource Addresses Intervention in Schools, Clinics, and Communities
Asperger's Syndrome: Intervening in Schools, Clinics, and Communities, edited by Linda J. Baker and Lawrence A. Welkowitz. 2005, has helpful and comprehensive information on diagnosis, pharmacotherapy, cognitive assessment of preschool and elementary school children, supporting elementary school children, counseling adolescents, supporting middle and high school students, complementary services such as sensory integration and pragmatics groups, and a section on special concerns, including a chapter on sexual relationships and a final chapter on legal issues. Various contributors include experts from the MIND Institute and from the Yale Child Study Center.
New Genetic Research Reveals Link Between Schizophrenia and Immune System
The National Alliance on Mental Illness (NAMI) issued the following press releases on its web site March 22:
Scientists have scanned the entire human genome for evidence of genes that play a role in schizophrenia and discovered a hot spot near two genes that regulate the immune system.
They found that markers within these genes were more common in people living with schizophrenia than in those without a history of the mental illness. Their study appeared this week in the journal Molecular Psychiatry.
Details of the study also are reported in the Los Angeles Times.
Update on the Campaign for Mental Health Reform
Look for an update on the Campaign for Mental Health Reform, of which NACBHDD is a partner, in the April newsletter. The Campaign is currently involved in activities related to SAMHSA reauthorization, the Mental Health is Integral to Health Act, SCHIP reauthorization, and authorization of programs related to the Mentally Ill Offender and Crime Reduction Act of 2003. See also the February newsletter for more information.
The Status of Federal Parity Legislation; Access Field Hearings Schedule
The following information on the status of federal parity legislation is reprinted from the March 14 DC Update, sent to members by Maeghan Gilmore. Emphasis has been added (in bold) to highlight some of the key points and differences in the proposed legislation.
Senators Edward Kennedy (D-MA), Michael Enzi (R-WY) and Pete Domenici (R-NM) introduced the Senator Paul Wellstone Mental Health Parity Act of 2007 (S 558). The Senate Health, Education, Labor and Pensions (HELP) Committee approved the bill by a vote of 18-3. The bill is recognized as compromise between businesses, the insurance industry and the mental health community. The House followed on March 7, 2007 and introduced their parity bill, H.R.1424, sponsored by Representatives Kennedy (D-RI) and Ramstad (R-MN). Their bill has 255 co-sponsors.
The 1996 federal parity law established annual and lifetime dollar limits. The current bills prohibit unequal co-payments and deductibles for mental health and addictions. Additionally, day and visit limits are pre-empted. While the Senate bill pre-empts state parity standards regarding financial and treatment limitations as well as other components of state law, the House bill will not pre-empt state laws that provide consumer protections.
Representatives Kennedy (D-RI) and Ramstad (R-MN) continue to conduct mental health parity hearings [through The Campaign to Insure Mental Health and Addiction Equity]. Check out the up-to-date schedule with local contact information at: www.equitycampaign.net/. (While the most recent hearing noted on the website is March 31, there is also information on the site about the advocacy network, Mental Health America in communities, events, and stigma watch).
April newsletter will feature NACBHDD member interview regarding parity testimony
Patricia Valentine, Deputy Director Allegheny County, Pennsylvania, Office of Behavioral Health, and NACBHDD member, testified during the Pittsburgh, Pennsylvania Mental Health Parity Hearing. For more information on her testimony, see
http://www.post-gazette.com/pg/07072/768980-85.stm. The April newsletter will feature an interview with Valentine about her testimony. As always, NACBHDD members are encouraged to share their local news and activities.
From a March 20 SAMHSA press release:
Two online resources now available from SAMHSA will help mental health and substance abuse professionals to organize and strengthen efforts around workforce development.
An Action Plan for Behavioral Health Workforce Development provides an overview of key findings of a multiyear process that showed how public and private collaboration by diverse stakeholders can strengthen the behavioral health workforce. This Action Plan articulates specific, actionable objectives to assist the Nation in transforming the behavioral health service delivery systems.
Strengthening Professional Identity: Challenges of the Addictions Treatment Workforce summarizes trends in addictions treatment that will help mental health and substance abuse professionals understand the challenges facing the addictions treatment workforce. This report addressed issues of recruitment, retention and staff development and provides recommendations for improving management, recruitment, education and accreditation, retention, and workforce infrastructure.
Both publications are available on the Web at http://www.samhsa.gov/matrix2/matrix_workforce.aspx. For related publications and information, visit http://www.samhsa.gov/.
SAMHSA Launches Searchable Database of Evidence-Based Practices in Prevention and Treatment of Mental Health and Substance Use Disorders
The new National Registry of Evidence-based Programs and Practices (NREPP) debuts online today, greatly expanding SAMHSA's efforts to help local organizations make informed decisions about evidence-based interventions for the prevention and treatment of mental health and substance use disorders.
NREPP is a searchable database with up-to-date, reliable information on the scientific basis and practicality of interventions. Users, such as community organizations and state and local officials, can perform custom searches to identify specific interventions based upon desired outcomes, target populations and service settings.
"The new NREPP is a major advancement in SAMHSA's efforts to translate substance abuse and mental health research into practice," said Terry Cline, Ph.D., SAMHSA Administrator. "As more interventions become available, NREPP will accelerate the adoption of effective, evidence-based services to prevent and treat mental health and substance use disorders in community-based settings, achieving the goal of SAMHSA's Science to Service Initiative."
Originally created in the 1990s, NREPP has been redesigned based on extensive input from scientific communities, service providers, expert panels and the public.
Key features of the new NREPP system include:
To have an intervention listed in NREPP, the intervention's developer submits required information about the intervention for expert review. Experts then rate the intervention on the quality of research supporting specific intervention outcomes, and on the availability of implementation resources to translate the scientific findings into routine practice. All NREPP reviewers are recruited, selected, and approved by SAMHSA based on their experience and areas of expertise.
NREPP initially will offer information on 25 interventions that have been examined and rated by experts. With more than 200 additional interventions under review, NREPP is expected to add five to 10 new interventions each month.
As NREPP grows, it will address service needs and gaps in the substance abuse and mental health fields. New interventions may be submitted for review each year in response to an annual Federal Register notice.
NREPP supports SAMHSA's Science to Service Initiative, which promotes greater adoption in routine clinical and community-based settings of those services that science has demonstrated to be effective in preventing and treating mental and substance use disorders. SAMHSA collaborates with the National Institutes on Drug Abuse, Alcohol Abuse and Alcoholism, and Mental Health on this agency-wide effort.
For more information about NREPP ratings, how to use NREPP to identify specific interventions, or how to submit an intervention for review, visit the Web site at http://www.nrepp.samhsa.gov/; contact NREPP at 1-866-43NREPP (1-866-436-7377); or send an e-mail to NREPP@samhsa.hhs.gov.
From a March 2 SAMHSA press release:
Enhancing Motivation for Change Inservice Training, which gives new substance abuse counselors the basics on motivating clients, is now available from the Substance Abuse and Mental Health Services Administration.
This training focuses on strategies to affect how motivated clients are to alter their substance use – to begin and stick to a change in their behavior. Clinicians have found the approaches in this training useful with populations characterized by denial and resistance, such as court-mandated offenders.
The new manual is based on Treatment Improvement Protocol (TIP) 35, Enhancing Motivation for Change in Substance Abuse Treatment and is written so an extensive background in training is not needed. The training approach includes presentation, discussion, group or partnered practice exercises, and between-session assignments to help participants practice new skills and integrate learning into their practices.
Participants will learn about change theory and motivational strategies, learn to assess clients' readiness for change, and develop skills for enhancing client motivation. This training would be particularly helpful for new counselors or clinicians who are unfamiliar with motivational enhancement. The eleven 1.5- to 2-hour modules include presentation instructions, PowerPoint slides, homework assignments, and handouts.
Enhancing Motivation for Change Inservice Training is available on the Web at http://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=17504. Copies may be obtained free of charge by calling SAMHSA's Health Information Network at 1-877-SAMHSA-7 (1-877-726-4727). Request inventory number PHD1135. For related publications and information, visit http://www.samhsa.gov/.
From a March 9 SAMHSA press release:
Mental Health Services in the Nation / Improved Quality of Care Highlighted
Coordinated primary and mental health and substance abuse care, adoption and application of quality improvement tools, population assessments and national mental health services statistics are contained in Mental Health, United States 2004. The compendium of the latest information available on mental health services, published every two years since 1983, was released today by the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS).
For the first time, this edition includes chapters on quality improvement and its application to the mental health field. Specialized topic areas discussed include a national overview of mental health consumer organizations in the United States and the role of information technology as a force that promotes transformation and improved quality of care.
Specific issues, population assessments and national service statistics in this compendium include the following:
Mental health care in primary care settings:
Mental Health, United States 2004 is available on the Web at http://mentalhealth.samhsa.gov/publications/allpubs/SMA06-4195/default.asp . Copies may be obtained free of charge from SAMHSA's National Mental Health Information Center at 1-877-SAMHSA-7 (1-877-726-4727). Request inventory number SMA-06-4195. For related publications and information, visit http://www.samhsa.gov/
From a March 12 SAMHSA press release:
SAMHSA to Fund Up To Eight Alternatives to Restraint and Seclusion Grants
SAMHSA is soliciting applications to support States in their efforts to adopt best practices to reduce and ultimately eliminate the use of restraint and seclusion in institutional and community- based settings that provide mental health services, including services for people with co-occurring substance abuse and mental health disorders. States will be able to increase the number of programs that implement alternative models to reduce/eliminate restraint and seclusion, including staff training models and other multi-faceted approaches, and collect data to measure the impact of these models on reducing the use of seclusion and restraint.
It is expected that up to $1.7 million will be available to fund up to 8 awards. Annual award amounts are expected to be about $214,000 per year in total cost for up to three years. The actual amount may vary, depending on the availability of funds. The grants will be awarded by SAMHSA's Center for Mental Health Services.
WHO CAN APPLY: Eligibility is limited to agencies of States, District of Columbia, Territories and American Indian/Alaska native tribal governments with jurisdiction over mental health issues for the target populations identified in the proposed applications. Applicants must be able to report incidents to their State Protections and Advocacy System, specifically the Protection and Advocacy for Individuals with Mental Illness (PAIMI) Program as required under the Children's Health Act of 2000. States that received a grant under the FY 2004 – 2006 Alternatives to Restraint and Seclusion are not eligible.
HOW TO APPLY: Applications for No. SM-07-005 are available by calling SAMHSA's Clearinghouse at 1-877-SAMHSA7, or by downloading from http://www.samhsa.gov/grants/index.aspx or www.grants.gov. Applicants are encouraged to apply on line using www.grants.gov.
APPLICATION DUE DATE: Must be received by May 11, 2007.
ADDITIONAL INFORMATION: Applicants with questions on program issues should contact John Morrow at 240-276-1783 or e-mail to john.morrow@samhsa.hhs.gov. For questions on grants management issues, contact Kimberly Pendleton at 240-276-1241 or e-mail Kimberly.Pendleton@samhsa.hhs.gov.
From a March 12 SAMHSA press release:
SAMHSA to Fund 15 Addiction Technology Transfer Centers (ATTC) Grants
The Substance Abuse and Mental Health Services Administration (SAMHSA) is soliciting applications for Addiction Technology Transfer Centers (ATTC). The ATTC program supports the workforce that provides addictions treatment services to 23 million Americans age 12 and older who need treatment for alcohol or illicit drug problems (NSDUH, 2005). The ATTCs assess the training and development needs of the substance use disorders workforce, and develop and conduct training and technology transfer activities to promote the adoption of evidence-based practices in substance use disorders treatment.
It is expected that approximately $7.8 million will be available to fund up to 15 awards.
Awards will be made to 14 Regional Centers and 1 National Coordinating Center. The annual award amount will range from $500,000 to $550,000 per year for up to five years. The actual amount may vary, depending on the availability of funds. Eligible applicants are domestic public or nonprofit entities, states and local governments, federally recognized American Indian/Alaska native tribes and tribal organizations, including public or private universities and colleges, and community and faith-based organizations. The grants will be awarded by SAMHSA's Center for Substance Abuse Treatment.
WHO CAN APPLY: Eligible applicants are domestic, private and public nonprofit entities, including State and local governments, federally recognized American Indian/Alaska native tribes and tribal organizations, public or private universities and colleges, and community and faith-based organizations.
HOW TO APPLY: Applications for No. TI -07-001 are available by calling SAMHSA's Clearinghouse at 1-877-SAMHSA7, or by downloading from http://www.samhsa.gov/grants/index.aspx or www.grants.gov. Applicants are encouraged to apply on line using www.grants.gov
APPLICATION DUE DATE: June 1, 2007
ADDITIONAL INFORMATION: Applicants with questions on program issues should contact Catherine Nugent at 240-276-1577 or Cathy.Nugent@samhsa.hhs.gov. For questions on grants management issues, contact Kimberly Pendleton at 240-276-1421 or Kimberly.Pendleton@samhsa.hhs.gov.
